Influence of HeartMath Training Programme on Physiological and Psychological Variables

This study investigated biofeedback using heart rate variability (HRV) and psychometric measures. An original, mixed, quantitative and qualitative, within subjects, pre-test and post-test design was employed to evaluate the influence of a HeartMath training programme on measures of HRV, sense of coherence, mindfulness and relaxation in a convenience sample of 13 participants with age range 26-62 (M = 41.46, SD = 14.39) years. Participants were required to attend a three-hour workshop and complete 30 minutes of HeartMath training that included 5 different biofeedback sessions. Paired sample t-tests indicated significant differences on all outcome variables with medium to large effect sizes. Qualitative findings revealed positive and informative experiences of taking part in the research. Integrated findings supported and extended previous studies attesting to the value of HeartMath training

Influence of HeartMath Training Programme on Physiological and Psychological Variables

This study investigated biofeedback using heart rate variability (HRV) and psychometric measures. An original, mixed, quantitative and qualitative, within subjects, pre-test and post-test design was employed to evaluate the influence of a HeartMath training programme on measures of HRV, sense of coherence, mindfulness and relaxation in a convenience sample of 13 participants with age range 26-62 (M = 41.46, SD = 14.39) years. Participants were required to attend a three-hour workshop and complete 30 minutes of HeartMath training that included 5 different biofeedback sessions. Paired sample t-tests indicated significant differences on all outcome variables with medium to large effect sizes. Qualitative findings revealed positive and informative experiences of taking part in the research. Integrated findings supported and extended previous studies attesting to the value of HeartMath training

Is there a renoprotective value to leukodepletion during heart valve surgery? A randomized controlled trial (ROLO)

Background: Acute Kidney Injury (AKI) adversely affects outcomes after cardiac surgery. A major mediator of AKI is the activation of leukocytes through exposure to the cardiopulmonary bypass circuit. We evaluate the use of leukodepletion filters throughout bypass to protect against post-operative AKI by removing activated leukocytes during cardiac surgery. Methods: This is a single-centre, double-blind, randomized controlled trial comparing the use of leukodepletion versus a standard arterial filter throughout bypass. Elective adult patients undergoing heart valve surgery with or without concomitant procedures were investigated. The primary clinical outcome measured was the development of AKI according to the KDIGO criteria. Secondary measures included biomarkers of renal tubular damage (urinary Retinol Binding Protein and Kidney Injury Molecule-1), glomerular kidney injury (urinary Micro Albumin and serum Cystatin C) and urinary Neutrophil Gelatinase Associated Lipocalin, as well as the length of hospital stay and quality of life measures through EQ-5D-5L questionnaires. Results: The ROLO trial randomized 64 participants with a rate of recruitment higher than anticipated (57% achieved, 40% anticipated). The incidence of AKI was greater in the leukodepletion filter group (44% versus 23%, risk difference 21, 95% CI − 2 to 44%). This clinical finding was supported by biomarker levels especially by a tendency toward glomerular insult at 48 h, demonstrated by a raised serum Cystatin C (mean difference 0.11, 95% CI 0.00 to 0.23, p = 0.068) in the leukodepleted group. There was however no clear association between the incidence or severity of AKI and length of hospital stay. On average, health related quality of life returned to pre-operative levels in both groups within 3 months of surgery. Conclusions: Leukocyte depletion during cardiopulmonary bypass does not significantly reduce the incidence of AKI after valvular heart surgery. Other methods to ameliorate renal dysfunction after cardiac surgery need to be investigated. Trial registration: The trial was registered by the International Standard Randomized Controlled Trial Number Registry ISRCTN42121335. Registered on the 18 February 2014. The trial was run by the Bristol Clinical Trials and Evaluation Unit. This trial was financially supported by the National Institute of Health Research (Research for Patient Benefit), award ID: PB-PG-0711-25,090

Rotational velocities of A-type stars. III. Velocity distributions

Aim - In this work, a sample of vsini of B9 to F2-type main sequence single stars has been built from highly homogeneous vsini parameters determined for a large sample cleansed from objects presenting the Am and Ap phenomenon as well as from all known binaries. The aim is to study the distributions of rotational velocities in the mass range of A-type stars for normal single objects. Methods - Robust statistical methods are used to rectify the vsini distributions from the projection effect and the error distribution. The equatorial velocity distributions are obtained for an amount of about 1100 stars divided in six groups defined by the spectral type, under the assumption of randomly orientated rotational axes. Results - We show that late B and early A-type main-sequence stars have genuine bimodal distributions of true equatorial rotational velocities due probably to phenomena of angular momentum loss and redistribution the star underwent before reaching the main sequence. A striking lack of slow rotators is noticed among intermediate and late A-type stars. The bimodal-like shape of their true equatorial rotational velocity distributions could be due to evolutionary effects.Comment: 16 pages, 10 figures, accepted in A&

Discharge Age and Weight for Very Preterm Infants in Six Countries: 2012-2020

BACKGROUND Postmenstrual age for surviving infants without congenital anomalies born at 24-29 weeks' gestational age from 2005 to 2018 in the USA increased 8 days, discharge weight increased 316 grams, and median discharge weight z-score increased 0.19 standard units. We asked whether increases were observed in other countries. METHODS We evaluated postmenstrual age, weight, and weight z-score at discharge of surviving infants without congenital anomalies born at 24-29 weeks' gestational age admitted to Vermont Oxford Network member hospitals in Austria, Ireland, Italy, Switzerland, the UK, and the USA from 2012 to 2020. RESULTS After adjustment, the median postmenstrual age at discharge increased significantly in Austria (3.6 days, 99% CI [1.0, 6.3]), Italy (4.0 days [2.3, 5.6]), and the USA (5.4 days [5.0, 5.8]). Median discharge weight increased significantly in Austria (181 grams, 99% CI [95, 267]), Ireland (234 [143, 325]), Italy (133 [83, 182]), and the USA (207 [194, 220]). Median discharge weight z-score increased in Ireland (0.24 standard units, 99% CI [0.12, 0.36]) and the USA (0.15 [0.13, 0.16]). Discharge on human milk increased in Italy, Switzerland, and the UK, while going home on cardiorespiratory monitors decreased in Austria, Ireland, and USA and going home on oxygen decreased in Ireland. CONCLUSIONS In this international cohort of neonatal intensive care units, postmenstrual discharge age and weight increased in some, but not all, countries. Processes of care at discharge did not change in conjunction with age and weight increases

Cretaceous/Tertiary boundary cephalopods.

122 p. : ill. (some col.), maps (some col.); 26 cm.Includes bibliographical references (p. 111-122).Geological investigations in the upper Manasquan River Basin, central Monmouth County, New Jersey, reveal a Cretaceous/Tertiary (= Cretaceous/Paleogene) succession consisting of approximately 2 m of the Tinton Formation overlain by 2 m of the Hornerstown Formation. The top of the Tinton Formation consists of a very fossiliferous unit, approximately 20 cm thick, which we refer to as the Pinna Layer. It is laterally extensive and consists mostly of glauconitic minerals and some angular quartz grains. The Pinna Layer is truncated at the top and is overlain by the Hornerstown Formation, which consists of nearly equal amounts of glauconitic minerals and siderite. The base of the Hornerstown Formation is marked by a concentration of siderite nodules containing reworked fossils. This layer also contains a few fossils of organisms that were living in the environment during the time of reworking. At some downdip sites, there is an additional layer (the Burrowed Unit), which is sandwiched between the top of the Pinna Layer and the concentrated bed of nodules. This unit is very thin and is characterized by large burrows piping down material from above. The Pinna Layer is abundantly fossiliferous and represents a diverse, nearshore marine community. It contains approximately 110 species of bivalves, gastropods, cephalopods, echinoids, sponges, annelids, bryozoans, crustaceans, and dinoflagellates. The cephalopods include Eutrephoceras dekayi (Morton, 1834), Pachydiscus (Neodesmoceras) mokotibensis Collignon, 1952, Sphenodiscus lobatus (Tuomey, 1856), Eubaculites carinatus (Morton, 1834), Eubaculites latecarinatus (Brunnschweiler, 1966), Discoscaphites iris (Conrad, 1858), Discoscaphites sphaeroidalis Kennedy and Cobban, 2000, Discoscaphites minardi Landman et al., 2004b, Discoscaphites gulosus (Morton, 1834), and Discoscaphites jerseyensis, n.sp. The dinoflagellates include Palynodinium grallator Gocht, 1970, Thalassiphora pelagica (Eisenack, 1954) Eisenack & Gocht, 1960, Deflandrea galeata (Lejeune-Carpentier, 1942) Lentin & Williams, 1973, and Disphaerogena carposphaeropsis Wetzel, 1933. These ammonites and dinoflagellates are indicative of the uppermost Maastrichtian, corresponding to the upper part of calcareous nannofossil Subzone CC26b. The mode of occurrence of the fossils in the Pinna Layer suggests an autochthonous accumulation with little or no postmortem transport. Many of the benthic organisms are preserved in life position. For example, specimens of Pinna laqueata Conrad, 1858, are oriented in a vertical position, similar to that of modern members of this genus. The echinoids also occur in aggregations of hundreds of individuals, suggesting gregarious feeding behavior. In addition, there are monospecific clusters of baculites and scaphites. These clusters are biological in origin and could not have been produced by hydraulic means. Scaphite jaws are also present, representing the first reports of these structures in the Upper Cretaceous of the Atlantic Coastal Plain. They occur both as isolated specimens and inside the body chamber, and indicate little or no postmortem transport. The Pinna Layer represents a geologically short interval of time. The fact that most of the animals are mature suggests that the community persisted for at least 5-10 years. If multiple generations of animals are present, perhaps reflecting multiple episodes of colonization and burial, then this unit probably represents more time, amounting to several tens of years. The fact that the Pinna Layer is truncated at the top implies a still longer period of time, amounting to hundreds of years. These age estimates are consistent with observed rates of sedimentation in nearshore environments. Iridium analyses of 37 samples of sediment from three sites in the Manasquan River Basin reveal an elevated concentration of iridium of 520 pg/g, on average, at the base of the Pinna Layer. The iridium profile is aymmetric with an abrupt drop off above the base of this unit and a gradual decline below the base. The elevated concentration of iridium is not as high as that recorded from some other Cretaceous/Tertiary boundary sections. However, it is sufficiently above background level to suggest that it is related to the global Ir anomaly documented at many other localities, and attributed to a bolide impact. The position of the iridium anomaly at the base of the Pinna Layer is inconsistent with the biostratigraphic data, because this anomaly occurs below the unit containing fossils indicative of the uppermost Maastrichtian. We present two alternative hypotheses: (1) If the enriched concentration of iridium is in place, it marks the Cretaceous/Tertiary boundary by reference to the global stratotype section and point at El Kef, Tunisia. The position of the iridium anomaly further implies that the Pinna community was living at the moment of impact and may even have flourished in its immediate wake. Subsequently, the community may have been buried by pulses of mud-rich sediment, possibly associated with enhanced riverine discharge following the impact. The Burrowed Unit may represent a subsequent pulse of riverine discharge that scoured the top of the Pinna Layer. (2) The iridium anomaly was originally located at the top of the Pinna Layer and was displaced downward due to bioturbation and/or chemical diffusion. This hypothesis implies that the Pinna Layer was deposited prior to the deposition of the iridium. The Pinna community may have died before or at the moment of impact. Erosion of the top of the Pinna Layer and deposition of the Burrowed Unit may have been associated with events immediately following the impact. In both hypotheses, the sea floor experienced an extended period of erosion and reworking in the early Danian, which may have lasted for several hundred thousand years, producing a concentrated lag of siderite nodules containing reworked fossils in the basal part of the Hornerstown Formation. This lag deposit is equivalent to the Main Fossiliferous Layer at the base of the Hornerstown Formation elsewhere in New Jersey. This period of erosion and reworking was probably associated with a transgression in the early Danian. The post-impact community was greatly reduced in diversity, with most of the species representing Cretaceous survivors

Adherence to antiretroviral therapy and the associated factors among people living with HIV/AIDS in Northern Peru : a cross-sectional study

Altres ajuts: This study was partially funded by a research Grant from the Fundació Autònoma Solidària (Resolució Convocatòria FSXXXIII-Peru); and the Oficina de Investigación y Creatividad Intelectual from the Universidad María Auxiliadora (OICI-001-2017).There are approximately 72,000 people living with HIV/AIDS (PLHIV) in Peru. Non-adherence to antiretroviral therapy (ART) is the most important factor for therapeutic failure and the development of resistance. Peru has achieved moderate progress in meeting the 90-90-90 targets, but only 60% of PLHIV receiving ART are virally suppressed. The purpose of this study was to understand ART adherence in the Peruvian context, including developing sociodemographic and clinical profiles, evaluating the clinical management strategies, and analyzing the relationships between the variables and adherence of PLHIV managed at a regional HIV clinic in Lambayeque Province (Northern Peru). This was a cross-sectional study with 180 PLHIV adults, non-randomly but consecutively selected with self-reported ART compliance (78.2% of the eligible population). The PLHIV profile (PLHIV-Pro) and the Simplified Medication Adherence Questionnaire (SMAQ) were used to collect sociodemographic information, clinical variables, and data specific to ART adherence. Descriptive analysis of sociodemographic and clinical characteristics was performed. Bivariate analysis was performed with the Mann-Whitney test, Chi square test, and Yates correction. The 180 PLHIV sample included 78.9% men, 49.4% heterosexual, 45% with a detectable HIV-1 viral load less than 40 copies/ml, 58.3% not consistently adherent, and only 26.1% receiving Tenofovir + Lamivudine + Efavirenz. Risk factors significant for non-adherence included concurrent tuberculosis, discomfort with the ART regime, and previous pauses in ART. Multivariate analysis of nested models indicated having children is a protector factor for adherence. Self-reported adherence appeared to be low and the use of first-line therapy is not being prescribed homogeneously. Factors associated with nonadherence are both medical and behavioral, such as having tuberculosis, pausing ART, or experiencing discomfort with ART. The Peruvian government needs to update national technical standards, monitor medication availability, and provide education to health care professionals in alignment with evidence-based guidelines and international recommendations. Instruments to measure adherence need to be developed and evaluated for use in Latin America

A practical solution: the Anthropocene is a geological event, not a formal epoch

The Anthropocene has yet to be defined in a way that is functional both to the international geological community and to the broader fields of environmental and social sciences. Formally defining the Anthropocene as a chronostratigraphical series and geochronological epoch with a precise global start date would drastically reduce the Anthropocene’s utility across disciplines. Instead, we propose the Anthropocene be defined as a geological event, thereby facilitating a robust geological definition linked with a scholarly framework more useful to and congruent with the many disciplines engaging with human-environment interactions. Unlike formal epochal definitions, geological events can recognize the spatial and temporal heterogeneity and diverse social and environmental processes that interact to produce anthropogenic global environmental changes. Consequently, an Anthropocene Event would incorporate a far broader range of transformative human cultural practices and would be more readily applicable across academic fields than an Anthropocene Epoch, while still enabling a robust stratigraphic characterization

Potent and Broad Neutralization of HIV-1 by a Llama Antibody Elicited by Immunization

Llamas (Lama glama) naturally produce heavy chain–only antibodies (Abs) in addition to conventional Abs. The variable regions (VHH) in these heavy chain–only Abs demonstrate comparable affinity and specificity for antigens to conventional immunoglobulins despite their much smaller size. To date, immunizations in humans and animal models have yielded only Abs with limited ability to neutralize HIV-1. In this study, a VHH phagemid library generated from a llama that was multiply immunized with recombinant trimeric HIV-1 envelope proteins (Envs) was screened directly for HIV-1 neutralization. One VHH, L8CJ3 (J3), neutralized 96 of 100 tested HIV-1 strains, encompassing subtypes A, B, C, D, BC, AE, AG, AC, ACD, CD, and G. J3 also potently neutralized chimeric simian-HIV strains with HIV subtypes B and C Env. The sequence of J3 is highly divergent from previous anti–HIV-1 VHH and its own germline sequence. J3 achieves broad and potent neutralization of HIV-1 via interaction with the CD4-binding site of HIV-1 Env. This study may represent a new benchmark for immunogens to be included in B cell–based vaccines and supports the development of VHH as anti–HIV-1 microbicides